<http://schema.org/articleBody>
"   What is it used for?   Relapsing/remitting multiple sclerosis in adults.    How does it work? Tecfidera capsules contain the active ingredient dimethyl fumarate, which is a type of medicine called an immunomodulator. Tecfidera capsules are used to treat multiple sclerosis (MS). In some people, this disease follows a course of relapse and remission, where symptoms worsen for a while, then improve before worsening again.  The symptoms of MS arise as a result of damage to the protective coating of the nerves, called the myelin sheath. The damage is caused by inflammation in the central nervous system and it stops the damaged nerve cells from working properly. It is not fully understood how dimethyl fumarate works in multiple sclerosis, because the disease and its cause are not fully understood. However, dimethyl fumarate appears to affect the way the cells in the immune system work and reduces the inflammation that can damage the nerve cells.  Tecfidera helps to reduce the frequency and severity of the relapses and may delay progression of the disease. It doesn\u2019t cure the disease.   How do I take it?   Tecfidera capsules should be taken with or after food. Taking the capsules with or after food helps to reduce some of the common side effects associated with the medicine, such as flushing, nausea, abdominal pain and diarrhoea.   Tecfidera capsules should be swallowed whole with a drink of water. They must not be broken, crushed, chewed, sucked or dissolved in water. This is because the capsules contain micro-tablets of the medicine with a special coating that helps prevent the medicine irritating the gut.   Tecfidera capsules should be taken twice a day. If you take the capsules at the same times each day it will help you remember to take them. The usual starting dose of Tecfidera is 120mg twice a day; this is taken for seven days and then increased to 240mg twice a day. However, always follow the instructions given by your doctor.  If you forget to take a capsule take it as soon as you remember. However, you must always leave at least four hours between your doses. If it is less than four hours until your next dose is due then just leave out the missed dose. Take the next dose as usual at your usual time. Do not take a double dose to make up for a missed dose.   Keep taking the capsules regularly every day until your doctor tells you to stop.    Warning!   Drinking large amounts of strong alcoholic drinks, such as spirits containing more than 30% alcohol by volume, should be avoided for at least one hour after taking Tecfidera capsules. Alcohol can interact with this medicine and may increase the risk of inflammation of the stomach (gastritis), especially in people already prone to problems with the gut.   This medicine can decrease the number of white blood cells in your blood. A low white blood cell count can increase your susceptibility to infections. For this reason, you will need regular blood tests to monitor your blood cells during treatment with this medicine. Tell your doctor immediately if you experience any high temperature (fever), flu-like symptoms or any other signs of infection while you are taking this medicine.   You will also need to have regular blood tests to monitor your kidney and liver function while you are taking this medicine.    Use with caution in   People with severely decreased liver function.  People with severely decreased kidney function.   People with low numbers of white blood cells called lymphocytes in their blood.  People with severe disease involving the stomach or intestines.     Not to be used in  People with severe active infections.  Pregnancy.  Breastfeeding.   The safety and effectiveness of this medicine have not been established in children and adolescents under 18 years of age. It is not recommended for this age group.  This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.   Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.   The safety of this medicine for use in pregnancy has not been established. For this reason, it should not be used during pregnancy unless considered essential by your doctor.  Women who could get pregnant should use an effective method of contraception (preferably non-hormonal, eg condoms) to prevent pregnancy while taking this medicine. If you think you could be pregnant at any point during treatment you should tell your doctor straight away. Seek further medical advice from your doctor.  It is not known if this medicine passes into breast milk. The manufacturer states that mothers who need to take this medicine should not breastfeed. Seek medical advice from your doctor.     Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.   Very common (affect more than 1 in 10 people)  Flushing. Diarrhoea.  Feeling sick.  Pain in the abdomen.  Ketones in the urine.     Common (affect between 1 in 10 and 1 in 100 people)  Inflammation of the linings of the stomach and intestine (gastroenteritis).  Being sick.  Indigestion.  Inflammation of the stomach (gastritis). Burning sensation.  Feeling hot.  Skin reactions such as redness, itching and rash.  Decrease in the number of white blood cells in the blood (leucopenia - see warning above).  Protein in the urine.   Alteration in the results of liver function tests.  The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist. If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it\u2019s necessary they&amp;#039;ll report it for you. You can also report side effects yourself using the yellow card website: www.mhra.gov.uk/yellowcard.   How can this medicine affect other medicines?  It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while having treatment with this one, to make sure that the combination is safe.  Immunomodulating medicines, immunosuppressants and anti-cancer medicines should be used with caution at the same time as treatment with dimethyl fumarate, because these medicines may have an additive effect on the cells in the immune system and could increase the risk of infections. This includes other medicines used to treat MS, such as fingolimod or natalizumab. However, short courses of corticosteroids used to help control flare-ups of MS have not been shown to increase the risk of infections.  There may be an increased chance of side effects on the kidneys if this medicine is used in combination with other medicines that can affect the kidneys, such as the following:  aminoglycoside antibiotics such as gentamicin  diuretics such as furosemide  lithium non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen, diclofenac.   This medicine affects part of the immune system. This means that vaccines may potentially be less effective if given during treatment, and live vaccines may cause serious infections. Live vaccines include: measles, mumps, rubella, MMR, oral polio, oral typhoid and yellow fever. It is recommended that live vaccines are not given to people being treated with this medicine.   Other medicines containing the same active ingredient  There are currently no other medicines available in the UK that contain dimethyl fumarate as the active ingredient.   Further reading For background information about our medicine factsheets, including the references used to produce them, click here. Last updated 11.12.2014 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/brain-and-nervous-system/a8925/tecfidera-dimethyl-fumarate/>